Individual provider Active NPI

Mitchell David Hersh

  • Pharmacist
  • Lake Worth, FL
National Provider Identifier
1174964308
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
27153 Issued in FL
Practice address
7752 Forestay Dr
Lake Worth, FL 33467-7820
Phone
(561) 642-4932
NPI assigned
Jul 16, 2013
Last updated
Jul 16, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 27153 FL Primary

Addresses

Primary practice location

7752 Forestay Dr
Lake Worth, FL 33467-7820

Mailing address

7752 Forestay Dr
Lake Worth, FL 33467-7820
Phone (561) 642-4932

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27153FLMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1174964308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7752 FORESTAY DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334677820",
            "telephone_number": "561-642-4932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7752 FORESTAY DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334677820",
            "telephone_number": "561-642-4932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSH",
        "first_name": "MITCHELL",
        "middle_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-16",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "27153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.